Definitions and online reliability assessment of elementary ultrasound lesions in Takayasu arteritis: a study from the OMERACT Ultrasound Working Group.
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Tomelleri Alessandro, Reider Simon J, Dejaco Christian, Schmidt Wolfgang A, Ponte Cristina, Hocevar Alojzija, Águeda Ana Filipa, Alibaz-Oner Fatma, Appenzeller Simone, Aschwanden Markus, Bastian Hans, Bosch Philipp, Camellino Dario, Casteleyn Vincent, Chrysidis Stavros, Daikeler Thomas, De Miguel Eugenio, Diamantopoulos Andreas P, Filippou Georgios, Goel Ruchika, Hanova Petra, Hartung Wolfgang, Ikeda Kei, Inanc Nevsun, Jousse-Joulin Sandrine, Juche Aaron, Karalilova Rositsa, Keller Kresten Krarup, Kjær Søren Geill, Kohler Minna J, Koster Matthew J, Macchioni Pierluigi, Mackie Sarah L, Milchert Marcin, Misra Durga Prasanna, Molina-Collada Juan, Monti Sara, Nakagomi Daiki, Naredo Esperanza, Nielsen Berit Dalsgaard, Ogasawara Michihiro, Roth Johannes, Schäfer Valentin S, Seitz Luca, Seitz Pascal, Shumnalieva Russka, Terslev Lene, van der Geest Kornelis S M, Vreju Florentin Ananu, D'Agostino Maria-Antonietta, Keen Helen I, Mandl Peter, Pineda Carlos, Duftner Christina, Bond Milena
Аннотация
METHODS: A Delphi survey was conducted among members of the OMERACT Ultrasound Working Group to agree upon the definitions of key elementary US lesions and arterial segments to be included. A subsequent web-based reliability exercise included US images from TAK patients and healthy controls depicting the consensual lesions. Experts scored each image in two separate rounds. Inter-rater and intra-rater reliability were assessed using Fleiss' and Cohen's kappa (κ), respectively.
RESULTS: Three Delphi rounds were completed with 47, 46, and 43 experts respectively. Consensus was reached on three lesions ('macaroni sign', stenosis, occlusion) and seven arterial segments (bilateral common carotid, subclavian, axillary arteries, abdominal aorta). Forty-five experts completed the reliability exercise. Inter-rater reliability was moderate to good (κ = 0.47-0.64), with the highest agreement for the 'macaroni sign' in the carotid artery (κ = 0.73). Intra-rater reliability was good (κ = 0.72-0.79), with lower agreement for stenosis and occlusion in the abdominal aorta.
CONCLUSIONS: This OMERACT initiative established consensus-based definitions for US lesions in TAK and identified key relevant arterial segments, providing a reliable basis for the development of a standardized US composite score.